The Beginning of the Dawn of a Golden Age in Medicine

Biotech has been the driver of the stock market since 2009 for good reason — amazing progress is happening in the drug world. Every month now, for the first time in history, we are starting to see FDA approvals of immunological cancer drugs, and we’ll start to see almost miraculous remissions of cancers in some people who had no chance of long-term survival.

If you think the FDA does little or nothing, or that the drug business is relatively static, go here for a list of recent approvals — more than 40 in the past week, and a number of them far more important than label changes.

This is just the beginning of the dawn of a golden age in medicine. The treatments being developed may add decades, not just a few years, to many people’s lives and could push the average age at which people die now — their 70s and 80s — to their 120s. This will happen in your lifetime.

The progress we are making is so high-tech that we have new names for medicines. We can’t call them drugs, because they’re not pills or shots. They’re therapies. They’re often personalized medicine, in which the components of the “drug” you receive was built from cells that came out of your own body.

These medicines no longer originate with large pharmaceutical companies as they once did. Big Pharmas were originally glorified chemical companies. They synthesized and formulated molecules that stopped diseases. Now the Big Pharmas buy the small pharmas’ research because only startup small companies intensely focused on a single platform can provide the energy, brainpower and innovation needed.

The only significant bugaboo in this process is how one country — the United States, which essentially pays for most of this and already has the highest medical costs in the world — can both finance this revolution and then expect its citizens to fork over $200,000-$1 million per therapy regimen, even if the medicine cures blindness or cancer. The numbers don’t add up, frankly.

The retort I hear when I bring up this subject among really smart people in the business of medicine and insurance, as I did at Harvard last week, is: “Don’t worry, it’s technology.” Huh? Well, we’re supposed to believe that the costs of technology decrease rapidly with time. That’s true of computer chips, although iPhones seem to be getting more expensive each year. Comparing hardware to gene editing feels sketchy to me.

If you believe the argument, then what happens in the intermediate term when new therapy costs are high and insurance companies balk? I see real trouble ahead. This nation is not about to let insurance companies tell parents of a 9-year-old girl that she will just have to go blind because the insurance company won’t pay the bill. And the insurance company is where changes are likely to land first. People are beginning to notice that the most obvious inefficiency of our health care system is insurance companies, which are simply middlemen who make too much and provide no significant value.

We are the only developed nation in the world with a system that uses hundreds of different insurance companies to pay our health care bills. It doesn’t take an economist to figure out that we may not need or want for-profit insurance companies that are trying to make profits for shareholders. Remember when BlueCross and BlueShield were nonprofit and designed to assist the public good? Yup, we had what was essentially a single-payer health care system.

Now insurance companies simply make everything more expensive, and they drive consumers and physicians alike crazy.

Meanwhile, I notice that the stocks of large hospital companies are down. That’s another area where there’s a lot of profit being squeezed out of your household budget. But what does it all mean to investors? If we want the medical miracles coming down the pipeline, we’ll have to figure out how to pay for them. As an investor, I wouldn’t want to own any health care-based insurance company stocks a few years from now.